In 2016, the Department of Health Care Services (DHCS) announced it would be pursuing a comprehensive strategy to strengthen the Coordinated Care Initiative and Cal MediConnect (CMC). One of the key areas DHCS focused on was improving referrals to Long-Term Services and Supports (LTSS). The effort included creating standardized LTSS referral questions for all CMC and Managed Long Term Services and Supports (MLTSS) plans to use in their Health Risk Assessments (HRAs). To accomplish this, DHCS convened a workgroup of 20 participants from a variety of stakeholder groups, including: advocates, LTSS providers, health plans, medical groups, and state agencies.

In February, DHCS released the “Cal MediConnect HRA Workgroup: Summary of Recommendations.” This report provides a set of standardized LTSS referral questions and guidance for plans on how to use them to identify members who may qualify for and benefit from LTSS. The plan letters take the worgroup recommendations and translate them into formal guidance for the Cal MediConnect and Medi-Cal managed care plans.

Please note that the DPL and APL numbers (17-00A, 17-00B and 17-00C) are only temporary for ease of reference until final numbers are assigned upon release of the finalized plan letters.